Individual
ANTONIA M FAVACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
430 MORTON PLANT ST, CLEARWATER, FL 33756-3398
(727) 841-8384
(727) 461-8206
Mailing address
430 MORTON PLANT STREET, CLEARWATER, FL 33756-0000
(727) 841-8384
(727) 461-8206
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
21770
FL
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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